Heart failure hospitalization in Romania – A national multiannual study based on administrative dataset collection
Abstract
Background
Heart failure (HF) is a leading cause of hospitalization and mortality worldwide, with a substantial burden in Central and Eastern Europe. Romania lacks long-term national HF registries, making real-world administrative data an important source of epidemiological evidence.
Methods
We conducted a retrospective national study, using aggregated DRG reimbursement data reported by all public and private hospitals in Romania, between 2017 and 2022. HF hospitalizations were identified using ICD-10 codes (I50.x, I11.0). Key indicators included annual “HF hospital cases” and “HF patients”. Age distribution, length of stay, in-hospital mortality, and readmission frequency were collected for annual HF cohorts, with comparisons between pre-pandemic and COVID-19 pandemic periods.
Results
HF accounted for up to 14% of all “hospital cases”, with 550,000–590,000 annual HF episodes before the pandemic, declining by ~45% during COVID-19 pandemic. Approximately 1.4 hospitalization episodes per heart failure patient were recorded annually. Mean age was 70.1 (+/- 10) years and most hospitalized patients were ≥65 years old, although nearly 30% were <65 years. Mean length of stay was 6.7 days. In-hospital mortality for heart failure was consistently double that of all hospitalizations (4% vs. 2% pre-pandemic, increasing to 8-9% during the pandemic). One-year readmissions were very frequent, with >20% HF-related readmissions.
Conclusions
HF represents a major and persistent burden on the Romanian medical system, characterized by high mortality and readmission rates. These findings underscore the need for improved post-discharge management and national strategies to optimize HF care.
© 2026 Ovidiu Chioncel, Dragos Vinereanu, Dan Dobreanu, Nona Chiriac, Antoniu Octavian Petris, Andi Dinita, Daniel Lighezan, Bogdan A. Popescu, published by Romanian Society of Cardiology
This work is licensed under the Creative Commons Attribution 4.0 License.